THE power of the Healing Fields’ Community Health Entrepreneurs (CHEs), comprising women, came to the fore during the Covid-19 pandemic when the existing public health infrastructure was stretched to a breaking point. Take the case of Sarita Devi, one of the CHEs in Mau district in Uttar Pradesh, who demonstrated how leadership, education, and collaboration could change things for the better. While explaining the benefits of handwashing and social distancing as part of Covid education, Sarita found that several households didn’t even have access to soap. Her leadership skills came to the fore immediately. She, in coordination with the block officers, arranged for soap in all the households.
A few months later, she went door-to-door to educate the community on the importance of getting vaccinated. Even here, she took upon a leadership role. During mobilisation, Sarita came across many individuals who couldn’t afford to travel to the vaccination centre, which was 10 kilometres away. Sarita convinced the gram pradhan that arranging vehicles to the vaccination centre could fetch him more votes during the next election.
At Healing Fields Foundation (HFF), we got to hear many such inspirational stories from across the 1200 villages where women CHEs led initiatives to tackle Covid-19.
The need for CHEs
The CHEs are trained in basic first aid and illness prevention so that they are not only a source of important information but can act as a first responder for minor health issues. During Covid-19, the HFF provided the CHEs with equipment like pulse oximeters and medicines and essentials for the vulnerable like ration kits, etc. Healing Fields utilised Give’s crowdfunding platform to raise over ₹10 lakh in funds for this effort. The power of crowdfunding allowed small individual donations to add up to achieve incredible impact, and the work of these individual CHEs can transform rural India.
Healing Fields Foundation (HFF), a not-for-profit organisation based in Hyderabad, provides training and support for women as health change agents in their communities. HFF works in rural areas of poorer states to impact change in the areas with the most significant need. The approach is holistic—working to prevent health problems, facilitate access to health services and entitlements from the government, treat minor concerns with care, and enable livelihoods and access to health products through entrepreneurship. 5,000 women have been trained as Community Health Entrepreneurs, reaching 6.25 million individuals in 10 states.
The CHEs work with all sections of their community to bring health education and lead behavioural change. The CHEs are women from underprivileged and marginalised communities, members of trust groups, self-help groups and microfinance institutions. The HFF selects them with the support of village pradhans and frontline health and nutrition functionaries (like ASHA, AWW and ANMs).
These entrepreneurs/leaders are trained to become empowered “agents of change” to improve their community’s health. The CHEs are trained in first aid, nutrition, sanitation, hygiene, menstrual health management, vaccination, maternal health, preventative health behaviour, illnesses and diseases, and entrepreneurship. They lead the efforts to educate women and girls in schools on most of the topics. They learn entrepreneurial skills such as establishing kitchen gardens in their villages.
The project empowers women through leadership development and providing livelihood opportunities. Access to income and leadership roles for women allows them to overcome social barriers and also become role models for women and girls. We have noticed that after becoming CHEs, there is a transformation in these women leaders. They are confident, their entrepreneurial skill is bringing them more income, they enjoy taking responsibility, and there is respect and recognition in the society.
We have noticed that CHEs are more confident and they speak publicly about issues related to their community and village before the administration. Further, the CHEs command respect and their opinions are sought on matters that concern the community.
The CHEs work across three crucial pillars: 1) Preventative health education, 2) Health and nutrition services, products and entitlements, and 3) leadership and empowerment. These three pillars intersect in fundamental ways, and synergies create a multiplier effect.
We see the power of these synergies in the work of CHE Kaushalya of Ballia, Uttar Pradesh. A woman in her village was in distress after repeated miscarriages. Kaushalya first took upon her role as the counsellor and educator. She spoke to the distressed woman and her family, and discovered family dynamics like fights with her mother-in-law and going without food for days at a time. Kaushalya used all her leadership skills and convinced the family that they should treat the woman well. In the subsequent pregnancy, Kaushalya used to visit the woman’s home every day to ensure that she was getting proper nutrition. She also used to educate the expectant mother about the importance of prenatal care.
The CHE ensured that the pregnant woman had access to the Anganawadi center and the Primary Health Center to ensure she was receiving supplemental nutrition and checkups. The pregnant lady delivered a healthy baby. Kaushalya did what CHEs are trained to do and beyond.
The CHEs just prove that when women in rural India are provided opportunities to excel, they can take up leadership roles and work for the benefit of the community.
Maya Welch leads strategy, communication, and monitoring and evaluation projects for Healing Fields Foundation.